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Perspective > Medscape > Fast Five Quizzes Fast Five Quiz: Test Your Knowledge on Key Aspects of Heart Failure Yasmine S. Ali, MD, MSCI March 21, 2018 Heart failure is the pathophysiologic state in which the heart, via an abnormality of cardiac function (detectable or not), fails to pump blood at a rate commensurate with the requirements of the metabolizing tissues or is able to do so only with an elevated diastolic filling pressure. In general, the mortality rate...
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IMAGES IN CLINICAL MEDICINE Electrocardiographic Changes in Hypothermia Eleftheria Kampouri, M.D., and Julien Vaucher, M.D. N Engl J Med 2018; 378:460 DOI: 10.1056/NEJMicm1704534 A 76-year-old woman with a history of dementia and coronary heart disease was brought to the emergency department after she had been found lying outdoors for an undetermined period; her core body temperature was 26°C (78.8°F) at presentation. An electrocardiogram showed prominent Osborn waves, al...
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IMAGES IN CLINICAL MEDICINE Phlegmasia Cerulea Dolens with Compartment Syndrome Hsin-Ti Lai, and Shu-Hung Huang N Engl J Med 2018; 378:658 DOI: 10.1056/NEJMicm1704996 An 81-year-old man with hypertension presented to the emergency department with pain and swelling of the left thigh and lower leg that had developed during the previous several hours. He had no history of recent surgery or trauma and no known personal or family history of clotting disorders. The left lower l...
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JAMA Diagnostic Test Interpretation February 6, 2018 Evaluating Thrombocytopenia During Heparin Therapy Yu-Min Shen, Heather Wolfe, Stephen Barman JAMA. 2018;319(5):497-498. doi:10.1001/jama.2017.21898 Case A 45-year-old man was hospitalized with abdominal pain. He was diagnosed with superior mesenteric vein thrombosis with mesenteric ischemia and treated with partial small bowel resection and 2 weeks of enoxaparin while hospitalized. Three weeks later, he presented ...
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JAMA Diagnostic Test Interpretation February 6, 2018 Evaluating Thrombocytopenia During Heparin Therapy Yu-Min Shen, Heather Wolfe, Stephen Barman JAMA. 2018;319(5):497-498. doi:10.1001/jama.2017.21898 Case A 45-year-old man was hospitalized with abdominal pain. He was diagnosed with superior mesenteric vein thrombosis with mesenteric ischemia and treated with partial small bowel resection and 2 weeks of enoxaparin while hospitalized. Three weeks later, he presented ...
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Images in Clinical Medicine Pneumomediastinum Associated with Influenza A Infection Christopher T. Mansbridge, Matthew Inada-Kim N Engl J Med 2018; 378: e1 DOI:10.1056/NEJMicm1702849   A  previously healthy 33-year-old man presented to the emergency department with a 10-day history of lethargy and feeling unwell. His temperature was 38.3°C, and he had tachycardia, with an oxygen saturation of 85% while breathing 15 liters of oxygen per minute through a nonrebreather ...
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Images in Clinical Medicine Ventriculoperitoneal-Shunt Placement for Normal-Pressure Hydrocephalus Mahmoud A. AbdelRazek, Nagagopal Venna N Engl J Med 2017; 377: e35 DOI:10.1056/NEJMicm1701226 A 70-year-old woman presented to the neurology clinic with a 2-year history of gait disturbance, cognitive impairment, and urinary incontinence. Examination revealed a Mini–Mental State Examination (MMSE) score of 12 (on a scale of 0 to 30, with higher scores representing better per...
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Images in Clinical Medicine Talaromyces marneffei Infection Zixiang Si,  Jianjun Qiao N Engl J Med 2017; 377: 2580 DOI:10.1056/NEJMicm1704164 A  29-year-old man presented to an outpatient clinic with a 2-month history of fever, cough, dyspnea, and weight loss, as well as skin lesions that had developed on his face, neck, trunk, arms, and legs over a period of 2 weeks. Physical examination revealed extensive umbilicated papules (Panel A). A biopsy specimen obtained from a ...
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IMAGES IN CLINICAL MEDICINE Pneumatosis Cystoides Intestinalis Yuusaku Sugihara, M.D., Ph.D., and Hiroyuki Okada, M.D., Ph.D. N Engl J Med 2017; 377:2266 DOI: 10.1056/NEJMicm1701357 A 48-year-old woman presented to an outpatient clinic with a several-month history of abdominal fullness. She also had a history of eosinophilic pneumonia, which had been treated continuously with glucocorticoids for 7 years. On examination, her abdomen was distended but soft, with normal bowe...
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Methemoglobinemia Due to Antifreeze Ingestion Andrew N. Farkas, Anthony Scoccimarro, Anthony F. Pizon N Engl J Med 2017; 377: 1993-1994 To the Editor: Ingestion of antifreeze that contains ethylene glycol produces acidosis, nephropathy, coma, and cardiovascular collapse.1 Previously, minimal increases in methemoglobin levels (to as high as 6%; normal value, < 1.0% or < 1.5%, depending on the assay) after ingestion of antifreeze have been reported,2 with no known caus...
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